1979, 10-10 Permit: 79-5638 Mechanical FixturesPLAN NUMBER APPLICATION/ PERMIT PERMIT NUMBER
SPOKANE COUNTY — BUILDING CODES DEPARTMENT M - 5<,-- bk�l
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
� 7 -rN LEGAL DESCRIPTION -SEE ATTACHED
LOT I BLOCK IbUUUIVISIUN PARCEL NUMBER/S
TYPE )KNEW ElALT. ElAD'N. ❑ RPL. EIMVE.
% WORK OF ❑ BLD. ❑ PLMB. MECH: ElM.H. ElPOOL ElOTHER
lu
equired Set Backs in Feet
OWNER
Orth South
PHONE
3.
Zone Classification
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
Type Const7
ADDRESS
ZIP
CONTRACTOR
aluation
PHONE
SPECIAL APPROVALS SPECIAL CONDITIONS:
DWL Area
a
4'
Storage
SEPA
ADDRESS
Split Level
IP
DESIG ER
PHONE
No. Baths
No. Floors
No. Rooms
Rec. Room
5.
ADDRESS
ZIP
CERTIFICATE
CHANGE OF USE FROM
I Recd.
TO
of EXEMPTION
6.
TYPE )KNEW ElALT. ElAD'N. ❑ RPL. EIMVE.
% WORK OF ❑ BLD. ❑ PLMB. MECH: ElM.H. ElPOOL ElOTHER
lu
equired Set Backs in Feet
GAS
Orth South
East West
ize of Parcel
Zone Classification
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
Type Const7
Occupancy
Sprinklered
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
❑Yes ❑No ❑ Req'd.
I
aluation
Building Area in Sq. Ft.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DWL Area
Basement Area
Garage Area
Storage
SEPA
Split Entry
Split Level
Rancher
Fire Marshall
Co. Engineer Other (Specify)
No. Baths
No. Floors
No. Rooms
Rec. Room
Zone Clearance
IN THIS SPACE,
CERTIFICATE
Req'd.
I Recd.
Not Rec
of EXEMPTION
DESCRIBE WORK
$ t �i 'At_.►_ i"Q� FaT- Pel M P4#y'�,ICT WORK FEES COLLECTED
04* *9.0,0
*9,00
*9.006
E *0.00
5637:2
10-10-79
9 6.479,
VALUATION Source
of
9, Utilities
GAS
ELECTRIC
WATER
SEWER
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. Plumbing
DATE SIGNATURE— Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD. Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer Other (Specify)
Utilities
!?j DD
TOTAL $
Zone Clearance
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist / THIS B CO $IA� MIT.
o
I DATE OFFICIA-b-1— — 1
APPROYOOR ISSUANCE
V
*9,O a 0.2